Healthcare publication editors frequently ask for my predictions about inpatient, virtual telemedicine in the coming year. You may have seen one of those guest posts published last month in Electronic Health Reporter.
I’ve recapped the predictions below, but to sum them up in one line: It’s going to be another good year for telemedicine―perhaps the best yet. Momentum has been building for the increased acceptance of telemedicine in the hospital setting. It’s the result of several factors, most importantly the increasing shortage of physicians available to staff hospitals and provide specialized care. As noted in an article published recently in FierceHealthcare, many types of surgical, diagnostic, and internal medicine specialists will soon be in as short supply as primary care doctors.
Another important factor will spur the growth of inpatient telemedicine in 2018: The decision by the Texas Medical Board to remove the requirement for an in-person consultation with a physician before a patient can be treated via telemedicine. You can read an excellent summary of this decision and its impact in mHealthIntelligence, and I’ll be writing more about it in future blogs. But for now, suffice it to say that the decision not only opens the door for explosive telemedicine growth in Texas, but is also an important symbolic victory for the wider acceptance of telemedicine nationwide.
Here are my other predictions for 2018. We see some of the same significant trends that have been gaining momentum, along with a few newcomers. Together, these top-five trends will impact hospital medicine in 2018 in both traditional and progressive ways.
1. Parity chaos won’t slow growth
The telemedicine industry’s growth continues rapidly despite the widespread confusion over reimbursement for telemed services from state to state. Why? Because most hospital leaders recognize that they face far more significant costs from the lack of proper physician and specialist coverage than from a less-than-optimal reimbursement rate for telehealth. A teleneurologist consult in the ED might be reimbursed at a lower rate than an in-person visit with an onsite neurologist, but keeping the stroke patient in the hospital could mean a $12,000 DRG reimbursement that the hospital would lose if the patient had to be shipped to a tertiary referral center for treatment. Which is the smarter investment? And more importantly, which scenario better serves the patient?
2. More LTACHs, micro-hospitals will utilize telemedicine
As micro-hospitals and long-term acute care hospitals (LTACHs) grow, they are looking for single-source providers of solutions, with one point of contact, one operating system, and one set of tools and processes. Telemedicine fits their models very well, helping them avoid contracting with a wide array of specialists to meet their patients’ needs. It’s another great opportunity for virtual telemedicine and for Eagle, and we expect continued growth in these new segments through 2018.
3. Growth will continue in metropolitan hospitals
Rural hospitals have long been a sweet spot for telemedicine. Recently, however, more metropolitan hospitals have seen the advantage of telemedicine in two key areas. When cross-coverage calls are handled by telemedicine teams, it takes the burden of floor call off night hospitalists who may already be overwhelmed with admissions. By the same token, telemedicine offers “surge protection,” providing assistance with patient admissions during ED bottlenecks, and cost-effective relief from hospitalist overload. In 2018, we expect to see an increasing number of metropolitan hospitals incorporating telemedicine into their clinical teams.
4. More virtual telemedicine partners will fill specialty gaps
Individual specialists in pulmonology, cardiology, nephrology, and other areas might be on call with a local hospital 24/7/365, with no backup for nights, weekends, holidays, or vacations. Telemedicine specialists share coverage with these physicians—individuals and small practices alike—to help ease the demands on them. For example, a community hospital has a local cardiologist on-call 15 days a month, and a telecardiology team on-call the other 15 days. This is just one real-world example of hospitals finding creative new ways to meet the increasing challenges of the physician shortage.
5. More hospitals will choose telemedicine over costly “quick fixes”
Stories about the physician shortage have become everyday news. In 2017, they were bleaker than ever. There are two obvious remedies for the crisis. Hospitals often use temporary “fixes,” hiring locum tenens physicians or “moonlighters” to fill in the gaps. It’s an expensive solution, and does little to solve the problem for the long term. More and more hospitals understand this, and are recognizing that telemedicine teams aren’t quick fixes, but are a sustainable solution, and quickly become an established and invaluable part of their onsite clinical team.